Change 09 Registration Form

March 6, 2009
11AM - 3PM
Bailey Hall, Gorham Campus

Name:
Email:
Phone #:
Are you a USM Student? Yes No
If no, what school?
Major:
Resident or Commuter? Resident Commuter
Year in School? Freshman Sophomore Junior Senior Senior+
Activities/Organizations You're Involved With?


Leadership Positions Currently Held


Any special accommodations needed?


***Non-USM Students:
There is a $10 registration fee to cover lunch and conference materials. Checks should be made out to the USM Student Senate. Please bring payment to the conference. We will provide an invoice once you have registered.